DIABETES

Diabetes mellitus refers to a group of diseases that affect how your body uses blood glucose, commonly called blood sugar. Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel.

If you have diabetes, no matter what type, it means you have too much glucose in your blood. Too much glucose can lead to serious health problems.

Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes — when your blood sugar levels are higher than normal, but not high enough to be classified as diabetes — and gestational diabetes, which occurs during pregnancy but may resolve after the baby is delivered.  -Mayo Clinic

DIABETES I                                                                          DIABETES II

BLOOD GLUCOSE

SIGNS AND SYMPTOMS

HYPERGLYCEMIA

HYPOGLYCEMIA

BLOOD GLUCOSE CONTROL

• Check BG before every meal and when you are having symptoms of hyper/hypoglycemia. Focus mainly on hyperglycemic symptoms as they will require insulin and medication whereas hypoglycemic symptoms require the consumption of sugar.
• Check BG on the side of the finger pad, rotating fingers to prevent soreness. Clean the site with alcohol first, then place the lancet on the finger pad and lance. Wipe the first drop of blood away with a cotton ball or swab. After the first drop is wiped away, apply a generous drop of blood into the glucose monitor, filling the window completely to provide the required amount. Hold pressure on the finger for a few seconds and read the monitor for the blood glucose.
• Keep a log of your results!
• Look for any variations or patterns in your results to determine what works and what does not work for you.

     Hemoglobin A1C

     Hemoglobin A1C will be checked every 3 months at the doctor’s office to see the average glucose levels over a longer time period.  If high, it reveals that glucose levels are not being well controlled. If in normal range, glucose levels are being controlled.  This allows the doctor to see compliance with insulin/medication regimen. 

MEDICATION MANAGEMENT

• Know what medications you are taking.
• Know why you are taking them.
• Know how to take them.
• If you don't know the answer to any of these questions, ask your doctor or your pharmacist for help.

Types of Diabetes Medication

1. Insulin injections –
Insulin injections replace the insulin that the body normally produces on its own. This is the only medication used in Type 1 diabetes but is also used in the management of some cases of Type 2 diabetes.

2. Non-insulin injectable medication –
These medications help to lower blood glucose levels in Type 2 diabetes. Examples include: Byetta, Victoza.

3. Oral medications –
These medications work in various ways to reduce the blood glucose levels in Type 2 diabetes. Examples include: Metformin, Amaryl, Actos, Januvia.

DIET

Every individual needs to eat healthy!!  Diabetics can still enjoy a full and wide ranging diet, there just simply has to be more thought and planning ahead happen.  The body needs 3 vital nutrients: carbohydrates, protein, and fats.  Carbohydrates provide energy; they are what provide glucose that feeds all the cells in the body.  Protein help repair the body and build muscle.  Fats must be taken in moderation.  Fats help your body absorb vitamins and also help to make you feel full.  Each of those 3 are vital to the health of our bodies.

Carbohydrates raise blood glucose levels.  Diabetics need to limit intake of carbohydrates per meal to maintain optimum blood glucose levels.  When looking at a nutrition label pay attention to the total carbohydrates number as that is the number that must be controlled. 

 There are several different methods in keeping blood glucose levels in control with diet:

Counting carbohydrates.

 Because carbohydrates break down into glucose, they have the greatest impact on your blood glucose level. It's important to make sure your timing and amount of carbohydrates are the same each day, especially if you take diabetes medications or insulin. Otherwise, your blood glucose level may fluctuate more. A general rule with this method is to allot 75 carbohydrates per meal

Exchange system
One serving in a group is called an "exchange." An exchange has about the same amount of carbohydrates, protein, fat and calories — and the same effect on your blood glucose — as a serving of every other food in that same group. So, for example, you could exchange — or trade — one small apple for 1/3 cup of cooked pasta, for one carbohydrate serving.

Glycemic Index

Some people who have diabetes use the glycemic index to select foods, especially carbohydrates. Foods with a high glycemic index are associated with greater increases in blood sugar than are foods with a low glycemic index. Complex carbohydrates that are high in fiber — such as whole-grain rice, bread or cereals — have a lower glycemic index than do simple carbohydrates — white bread or white rice, for example — and usually are preferred to highly processed foods. But low-index foods aren't necessarily always healthier, as foods that are high in fat tend to have lower glycemic index values than do some healthier options.

Mayo Clinic: Diabetes Diet

EXERCISE

There are many benefits to exercising but specifically for diabetics:

·           Exercise helps your cells to increase sensitivity to insulin created by your pancreas or     provided through medications. 

·         Keeps the body strong and healthy.

·         Supports the body in glucose absorption and maintenance.

·         lowers blood pressure and cholesterol

·         lowers your risk for heart disease and stroke

·         burns calories to help you lose or maintain weight

·         increases your energy for daily activities

·         helps you sleep better

·         relieves stress

·         strengthens your heart and improves your blood circulation

·         strengthens your muscles and bones

·         keeps your joints flexible

·         improves your balance to prevent falls

·         reduces symptoms of depression and improves quality of life

Make a plan that is tailored to you by talking with your doctor, checking your sugar and insulin requirements, and finding exercises that work for you. This should help you and not hurt you, so adjust it the way that you need it. If hypoglycema/hyperglycemia symptoms occur while exercising, check your blood sugar! Always talk to your doctor before making a change in your exercise plan to prevent complications.

Always be prepared to treat hypoglycemia while exercising. Have a quick carbohydrate or sugar such as a sport’s drink, regular soda, or glucose tablets handy at all times just in case. Type II diabetics are still at risk for hypoglycemia, but this risk is much less than someone with Type I diabetes. If you do have a hypoglycemic episode, eat some type of sugar or carbohydrate, wait 15-20 minutes, then recheck your blood glucose.

Example exercises for seniors:

•    Focus on balance exercises, flexibility exercises, endurance, and strength.
•   Avoid strenuous exercises and exercises that raise blood pressure significantly.
•  Yoga, tai chi, side leg raises, and knee extensions are balance
• Flexibility: Stretch all muscles out to provide elasticity, strength, and prevent injuries.
•  Strength: Works with balance many times. Use light weights or bands to work with strength, but do NOT overdo it. Do not be so strenuous as this can cause high blood pressure and retinopathy, a common complication of diabetes.
•  Endurance: Walking, running, jogging, swimming. This helps with the heart and lungs as well as prevents or delays cancer and other complications of diseases.
• For more information go to BD Medical

Exercising with Diabetes Complications
Know what kinds of exercises work for you and what you should avoid.  Follow the link to see what you should avoid if you have another disease process.Exercise with Diabetes

Preventing Injury

• Warm up for 5 minutes before exercising and cool down for 5 minutes when you are finished exercising.
•  Avoid extreme temperatures while exercising.
•  Stay hydrated! Drink plenty of water before, during, and after exercising.
• Stop your activity if you feel light-headed, chest pain, or blood sugar is low.